|
Alkaline phosphatase
|
$35.40 |
$35.40 |
$35.40 |
$46.00
|
|
Allergen alpha lactalbumin ige
|
$48.60 |
$48.60 |
$48.60 |
$48.57
|
|
Allergen egg white ige
|
$13.80 |
$13.80 |
$13.80 |
$36.60
|
|
Allergen specific ige qual multi scrn ea
|
$24.60 |
$24.60 |
$24.60 |
$24.01
|
|
Allograft 160mg placental salera mini membrane
|
$6,611.20 |
$6,611.20 |
$6,611.20 |
$666.00
|
|
Allograft allowrap 4x4cm dry 16sqcm
|
$13,037.12 |
$13,037.12 |
$13,037.12 |
$5,399.16
|
|
Allograft amnioexcel plus 17mm disk
|
$16,359.20 |
$16,359.20 |
$16,359.20 |
$3,380.36
|
|
Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet
|
$12,541.67 |
$12,541.67 |
$12,541.67 |
$9,018.12
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$10,174.10 |
$10,174.10 |
$10,174.10 |
$5,213.60
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$46,185.43 |
$46,185.43 |
$46,185.43 |
$22,984.85
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$31,006.47 |
$31,006.47 |
$31,006.47 |
$1,115.40
|
|
Allograft graftjacket 2x12cm-q4107-cost per sq cm
|
$26,239.58 |
$26,239.58 |
$26,239.58 |
$4,732.60
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$24,775.26 |
$24,775.26 |
$24,775.26 |
$4,037.03
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$8,121.96 |
$8,121.96 |
$8,121.96 |
$4,384.80
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$9,276.62 |
$9,276.62 |
$9,276.62 |
$1,707.62
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$2,592.00 |
$2,592.00 |
$2,592.00 |
$9.62
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$175.20 |
$175.20 |
$175.20 |
$175.20
|
|
Alpha-fetoprotein amniotic
|
$35.40 |
$43.20 |
$43.20 |
$96.20
|
|
Alpha-fetoprotein tumor marker
|
$60.60 |
$60.60 |
$60.60 |
$102.00
|
|
Alprostadil for injection
|
$764.10 |
$764.10 |
$764.10 |
$519.93
|
|
Alteplase 100 mg infusion from pyxis vial
|
$36,961.56 |
$39,707.28 |
$39,707.28 |
$14,503.48
|
|
Alt/sgpt
|
$49.20 |
$49.20 |
$49.20 |
$44.68
|
|
Aluminum - quest
|
$44.40 |
$54.60 |
$54.60 |
$81.49
|
|
Alveoloplasty each quadrant
|
$21,118.08 |
$21,118.08 |
$21,118.08 |
$3,837.72
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$48.96 |
$48.96 |
$52.62 |
$38.68
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$30.60 |
$32.88 |
$32.88 |
$37.32
|
|
Aminolevulinic acid delta
|
$36.60 |
$36.60 |
$36.60 |
$74.10
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$16.80 |
$18.06 |
$18.06 |
$45.56
|
|
Amiodarone 50 mg/ml intravenous solution
|
$8.46 |
$12.96 |
$19.86 |
$61.68
|
|
Ammonia
|
$117.00 |
$117.00 |
$117.00 |
$114.40
|
|
Amniocentesisdiagnostic 59000
|
$823.20 |
$823.20 |
$823.20 |
$943.50
|
|
Amniocentesis therapeutic
|
$864.60 |
$864.60 |
$864.60 |
$778.57
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$201.60 |
$216.60 |
$216.60 |
$123.53
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$403.02 |
$736.44 |
$736.44 |
$451.51
|
|
Ampicillin 1 gram solution for injection
|
$32.10 |
$56.28 |
$60.48 |
$63.82
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$34.32 |
$65.76 |
$72.00 |
$58.36
|
|
Amp metatarsal w/toe single 28810
|
$10,630.92 |
$10,630.92 |
$29,871.29 |
$4,313.40
|
|
Amputate metacarpal bone 26910
|
$17,660.64 |
$17,660.64 |
$17,660.64 |
$3,839.54
|
|
Amputation follow-up surgery
|
$18,901.02 |
$18,901.02 |
$18,901.02 |
$3,839.54
|
|
Amputation toe interphalangeal joint
|
$14,764.80 |
$19,907.92 |
$21,457.98 |
$3,981.06
|
|
Amputation toe metatarsophalangeal joint
|
$19,914.28 |
$20,399.34 |
$29,871.29 |
$3,814.50
|
|
Amylase
|
$63.00 |
$63.00 |
$63.00 |
$83.20
|
|
Ana ds-dna
|
$28.20 |
$28.20 |
$28.20 |
$58.63
|
|
Analysis gene f2 20210g>a variant
|
$235.80 |
$235.80 |
$235.80 |
$207.48
|
|
Analysis gene f5 leiden variant
|
$178.20 |
$178.20 |
$178.20 |
$219.13
|
|
Anaplsma phgcytophlm amp prb
|
$93.00 |
$93.00 |
$93.00 |
$88.00
|
|
Anca screen with reflex to titer -quest
|
$80.40 |
$80.40 |
$80.40 |
$100.32
|
|
An cholangiogram percutaneous compl
|
$5,892.00 |
$5,892.00 |
$5,892.00 |
$2,624.13
|
|
Androstanediol
|
$62.40 |
$62.40 |
$62.40 |
$103.80
|
|
An fluoro guide for cvp
|
$562.20 |
$562.20 |
$46,823.86 |
$510.17
|
|
Angio balloon ctrl dialysis seg add-on
|
$7,054.80 |
$7,054.80 |
$7,054.80 |
$5,341.83
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$143.10 |
$630.00 |
$1,373.04 |
$5,172.70
|
|
Angio trnslmnl balloon same artery ea addl
|
$7,921.80 |
$7,921.80 |
$7,921.80 |
$4,683.90
|
|
Angio trnslmnl balloon same artery ini
|
$7,921.80 |
$7,921.80 |
$7,921.80 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$8,466.00 |
$8,466.00 |
$8,466.00 |
$4,438.34
|
|
Angio trnslmnl balloon same vein ini
|
$8,466.00 |
$8,466.00 |
$8,466.00 |
$8,466.00
|
|
Anidulafungin injection
|
$801.78 |
$861.30 |
$861.30 |
$297.63
|
|
Ankle arthroscopy/surgery
|
$25,365.58 |
$25,365.58 |
$25,365.58 |
$6,193.84
|
|
Ankle arthroscopy/surgery
|
$43,138.85 |
$43,138.85 |
$43,138.85 |
$3,839.54
|
|
Ankle arthroscopy/surgery
|
$18,468.66 |
$18,468.66 |
$41,086.22 |
$3,839.54
|
|
Ankle X-ray
|
$329.40 |
$329.40 |
$329.40 |
$351.20
|
|
Anoscopy ablation lesion 46615
|
$16,667.78 |
$16,667.78 |
$16,667.78 |
$3,245.23
|
|
Anoscopy and dilation 46604
|
$6,921.78 |
$6,921.78 |
$6,921.78 |
$2,108.80
|
|
Ant colporrhaphy/rpr cyctocele 57240
|
$18,170.73 |
$18,170.73 |
$21,768.99 |
$5,741.00
|
|
Anterior asis pad
|
$187.13 |
$187.13 |
$187.13 |
$134.14
|
|
Anterior swing band
|
$665.14 |
$665.14 |
$665.14 |
$476.73
|
|
Anterior thoracic derotation
|
$223.16 |
$223.16 |
$223.16 |
$159.96
|
|
Anterior thoracic extension
|
$515.37 |
$515.37 |
$515.37 |
$365.76
|
|
Antibody bacterium, not elsewhere specified
|
$91.20 |
$91.20 |
$91.20 |
$57.85
|
|
Antibody elution rbc reference
|
$151.20 |
$151.20 |
$151.20 |
$175.50
|
|
Antibody htlv/hiv confirm test
|
$48.60 |
$48.60 |
$106.20 |
$114.40
|
|
Antibody htlv-i
|
$15.60 |
$16.80 |
$16.80 |
$48.57
|
|
Antibody htlv-ii
|
$15.60 |
$16.80 |
$16.80 |
$36.00
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$448.80 |
$448.80 |
$448.80 |
$218.30
|
|
Antibody id rbc panel
|
$283.80 |
$283.80 |
$283.80 |
$283.80
|
|
Antibody influenza virus
|
$44.40 |
$44.40 |
$44.40 |
$53.28
|
|
Antibody screen rbc
|
$75.00 |
$75.00 |
$75.00 |
$102.05
|
|
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution
|
$14,493.60 |
$17,107.20 |
$17,107.20 |
$6.57
|
|
Anti mog serum - sendout
|
$164.40 |
$164.40 |
$164.40 |
$112.81
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$20.40 |
$20.40 |
$20.40 |
$42.35
|
|
Ant instr 2-3 vert segm 22845
|
$42,257.90 |
$42,257.90 |
$42,257.90 |
$1,748.00
|
|
Antinuclear antibodies
|
$133.20 |
$133.20 |
$133.20 |
$90.00
|
|
Antinuclear antibodies titer
|
$114.60 |
$114.60 |
$114.60 |
$77.00
|
|
Antiphosphatidylserine antibody
|
$41.40 |
$41.40 |
$41.40 |
$67.60
|
|
Antistreptolysin o screen
|
$58.80 |
$58.80 |
$58.80 |
$58.30
|
|
Antistreptolysin o titer
|
$63.00 |
$63.00 |
$63.00 |
$55.44
|
|
Antithrombin iii activity
|
$114.00 |
$114.00 |
$114.00 |
$112.70
|
|
Anti-thymocyte glob (equine)(1:1000) intradermal test dose
|
$18,524.40 |
$18,524.40 |
$18,524.40 |
$7,544.81
|
|
Antithymocyte globuln rabbit
|
$4,097.28 |
$4,097.28 |
$4,097.28 |
$1,958.74
|
|
Ant/post colporrhap/enterocele rpr 57265
|
$21,615.48 |
$21,615.48 |
$24,518.76 |
$5,339.00
|
|
Aortic dysfunction/dilation
|
$1,437.00 |
$1,437.00 |
$1,437.00 |
$992.40
|
|
Aortic dysfunction/dilation
|
$1,437.00 |
$1,437.00 |
$1,437.00 |
$1,525.60
|
|
Apc gene dup/delet variants
|
$465.60 |
$465.60 |
$465.60 |
$400.00
|
|
Apc gene full sequence
|
$1,297.20 |
$1,297.20 |
$1,297.20 |
$1,255.20
|
|
Apheresis wbc
|
$5,605.80 |
$5,605.80 |
$5,605.80 |
$3,250.39
|
|
Apl(pml-rara) quant - sendout
|
$399.60 |
$399.60 |
$399.60 |
$465.60
|
|
Appendix Removal (Laparoscopic)
|
$17,820.94 |
$22,686.91 |
$49,830.77 |
$6,870.89
|
|
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm
|
$2,298.00 |
$2,298.00 |
$2,298.00 |
$2,164.64
|
|
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm
|
$1,939.20 |
$1,939.20 |
$1,939.20 |
$1,011.14
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$1,939.20 |
$1,939.20 |
$1,939.20 |
$549.08
|
